KRS 205.5510: Definitions for KRS 205.5510 to 205.5520.

As used in KRS 205.5510 to 205.5520, unless the context otherwise requires:

(1) "Department" means the Department for Medicaid Services;

(2) "Managed care organization" has the same meaning as in KRS 205.532;

(3) "Pharmacy benefit manager" has the same meaning as in KRS 304.9-020;

(4) "Spread pricing" means any technique by which a pharmacy benefit manager or

other administrator of pharmacy benefits charges or claims an amount from an

insurer or managed care organization for pharmacy or pharmacist services,

including payment for a prescription drug, that is different than the amount the

pharmacy benefit manager or other administrator pays to the pharmacy or

pharmacist that provided the services; and

(5) "State pharmacy benefit manager" means the pharmacy ben efit manager contracted

by the department, pursuant to KRS 205.5512, to administer pharmacy benefits for

all Medicaid recipients enrolled in a managed care organization in the

Commonwealth.